Christian Healthcare Ministries (CHM) is a legitimate health care sharing ministry, not a scam. It has operated continuously since 1981, holds an A+ rating from the Better Business Bureau, and its members shared $609 million in medical bills in 2025 alone. But “legit” and “works like insurance” are two very different things, and understanding that distinction is critical before you sign up.
CHM is a 501(c)(3) nonprofit where members voluntarily share each other’s medical costs. It qualified for the religious exemption under the Affordable Care Act, which required a health sharing ministry to have been in continuous existence since at least December 31, 1999. CHM easily meets that threshold. What it does not have is the regulatory framework of an insurance company. No state insurance commissioner oversees it, no law requires it to pay your claims, and its guidelines explicitly state that sharing is voluntary, not guaranteed.
How CHM Differs From Health Insurance
The most important thing to understand is that CHM is not insurance. When you pay your monthly contribution, you’re not buying a policy with legally enforceable benefits. You’re participating in a sharing program where other members’ contributions go toward your eligible medical bills, and yours go toward theirs. If CHM determines a bill doesn’t meet its guidelines, you have no right to appeal to a state insurance regulator.
CHM members are considered self-pay patients. You can visit any facility or physician that meets accepted standards of care, and providers don’t need prior approval from CHM to treat you. That freedom of choice is a genuine advantage over narrow insurance networks. But it also means you’re responsible for negotiating prices, and you’ll need to pay upfront in many cases before CHM reimburses you. The typical sharing turnaround time is 50 to 70 days after you submit a bill.
What CHM Covers and What It Doesn’t
CHM shares costs for doctor visits, hospital stays, surgeries, maternity, and other medically necessary treatments. It offers three program levels (Bronze, Silver, and Gold) with different monthly costs and per-incident limits, all capped at $125,000 per illness unless you add supplemental coverage.
The exclusions are where many members run into trouble. CHM does not share costs for:
- Routine and preventive care, including wellness visits and screening tests
- Mental health treatment, including psychological counseling and psychiatric care
- Prescriptions beyond six months for any single condition (with limited exceptions for cancer and transplant patients)
That prescription limit is particularly significant if you have a chronic condition like diabetes or high blood pressure. After six months, you’re covering those medication costs yourself. And because preventive care isn’t shared, routine bloodwork, mammograms, colonoscopies, and annual physicals all come out of your own pocket.
Pre-Existing Conditions
CHM does share pre-existing condition costs, but on a phased schedule that’s far more restrictive than what the ACA requires of insurers. In your first year of membership, bills for a pre-existing condition are eligible for sharing up to $15,000. That cap rises to $25,000 across the first two years, then $50,000 across the first three years. After three full years of membership, the condition is no longer considered pre-existing.
A condition is classified as “maintained” (and therefore pre-existing) unless you’ve gone at least 90 days without testing or treatment, your provider confirms no further care is needed, and your records show you’re cured or on a stable maintenance regimen. If you’re managing an ongoing health issue when you join, plan for limited support in those early years.
Catastrophic Coverage Through CHM Plus
The base $125,000 per-illness cap can be a serious vulnerability. A complicated surgery, a cancer diagnosis, or a multi-week ICU stay can easily exceed that. CHM offers an add-on called CHM Plus for $42 per month per unit that raises those limits. Gold members with CHM Plus get unlimited cost support per illness. Silver and Bronze members get an additional $100,000 per illness per year, up to a total of $1 million per illness.
If you’re considering CHM as your primary coverage, CHM Plus isn’t really optional. Without it, a single serious medical event could leave you with six-figure bills that no one is obligated to help you pay.
Lifestyle and Eligibility Requirements
CHM requires members to affirm a statement of Christian faith and agree to live according to biblical principles. While CHM’s specific lifestyle requirements are less restrictive than some competitors (Medi-Share, for example, excludes maternity costs for unmarried members and requires members to enroll in a higher-cost tier if they gain significant weight), the faith-based framework shapes everything about how the ministry operates. Abortion services are not covered. Injuries related to drug or alcohol use may not be eligible.
The Regulatory Gap
Health care sharing ministries occupy a legal gray zone. They’re exempt from state insurance regulations in most states, which means there’s no guarantee of solvency, no required reserve funds, and no state-backed safety net if the organization can’t meet its obligations. This doesn’t mean CHM is likely to collapse. Its track record spans over 40 years, and it processed over $1.5 billion in submitted bills in 2025. But the absence of regulatory oversight is a real structural risk that insurance plans don’t carry.
That regulatory gap has created problems in the broader sharing ministry space. In 2025, Washington state’s insurance commissioner fined a different sharing ministry called ClearShare Health $275,000 for essentially selling insurance without a license. ClearShare collected over $524,000 in monthly contributions from Washington consumers while paying only $54,201 toward their expenses. CHM is not ClearShare, but the incident illustrates why the lack of oversight matters: when a sharing ministry underperforms, members have limited recourse.
Who CHM Works For
CHM tends to be a reasonable option for people who are generally healthy, don’t take long-term medications, can handle the financial risk of exclusions, and want lower monthly costs than marketplace insurance. Monthly contributions can run significantly less than ACA premiums, especially for families. The trade-off is real, though. You’re giving up guaranteed coverage for preventive care, mental health, and chronic disease management, and you’re accepting that bill sharing is voluntary rather than contractually guaranteed.
For someone with ongoing health needs, especially chronic conditions requiring daily medication or regular mental health care, the exclusions and pre-existing condition limits make CHM a poor fit. You’d be paying monthly contributions while covering many of your actual health expenses yourself. And if you qualify for ACA subsidies based on your income, marketplace plans may cost less than CHM while offering broader, legally guaranteed coverage.